AB1340 PREVALENCE OF THE WRISTS AND HANDS SYNOVITIS IN SUBGROUPS OF PATIENTS FOLLOWED FOR SYSTEMIC LUPUS ERYTHEMATOSUS.
Authors: N. Khaldoun, S. Haid, L. Soumia, L. Boulegheb, F. Rahal, I. Allam, R. Djidjik, N. Brahumi, A. Ladjouze-Rezig, F. Hanni
Journal: Annals of the Rheumatic Diseases (2022)

Background Joint damage is one of the most common manifestations of SLE. Represented by the presence of arthralgia or arthritis, with or without deformities or erosions. Musculoskeletal ultrasound allows evaluation of the inflammatory joint damage for more targeted therapeutic approach. Objectives The aim of this study was to estimate the prevalence of the wrists and hands synovitis (WHS) in subgroups of patients with systemic lupus erythematosus (SLE) and to compare them with each other. Methods One hundred and sixty-nine patients with SLE were consecutively recruited in the rheumatology unit (consultation or hospitalization) of the Ben Aknoun hospital, Algiers-Algeria. Stratification into subgroups was carried out: non-deforming non-destructive patients (NDND), rhupus patients (if coexistence of lupus and rheumatoid arthritis criteria), patients with moderate deforming arthropathy (MDA) or Jaccoud arthropathy according to the score of the Spronk index. For each patient, demographic data, duration of SLE evolution and joint involvement were collected, a standard inflammatory biology report and screening for rheumatoid factor (RF) and anti-CCP (ACPA) were requested. A musculoskeletal ultrasound of the wrists, MCP and PIP (from the 2nd to the 5th rays) was performed with a search for synovitis and erosions, the ultrasound examination was preceded by the calculation of the SLEDAI score and the HAQ score. Results 169 patients were recruited: 135 NDND, 18 rhupus, 10 Jaccoud, 6 MDA, respective mean age of 38.38 ± 11.79, 39.39 ± 11.74, 41.10 ± 9.5, 47 ± 9.35 years. The mean duration of lupus was 8.23 ​​± 6.97, 12.33 ± 8.71, 13.10 ± 6.6 and 15 ± 5.93 years, respectively. The mean duration of joint involvement was 7.38 ± 6.920, 12.22 ± 8.84, 13.10 ± 6.6, 15 ± 5.93 years. The positive CRP was found respectively in 20%, 38.9%, 20%, and 16.7%. The frequency of WHS, RF, ACPA and erosions was significantly higher in the rhupus group compared to that of NDND (p &lt;0.001). No difference in mean SLEDAI scores between subgroups. The mean HAQ score was higher in patients in the rhupus and Jaccoud groups compared to the mean score in patients in the NDND and MDA group (p &lt;0.0001). Conclusion Our results confirm that rhupus patients have more inflammatory and erosive involvement than other lupus subgroups. It represents an overlap between rheumatoid arthritis and lupus more than a separate entity. We have also shown that deforming arthropathies without structural damage correspond to a late course in a group of patients initially non-deforming non-destructive. References [1]Mosca M, Tani C, Carli L, Vagnani S, Possemato N, Delle Sedie A, et al. The role of imaging in the evaluation of joint involvement in 102 consecutive patients with systemic lupus erythematosus. Autoimmun Rev. 2015;14(1):10–15. [2]Gabba A, Piga M, Vacca A, Porru G, Garau P, Cauli A, et al. Joint and tendon involvement in systemic lupus erythematosus: an ultrasound study of hands and wrists in 108 patients. Rheumatology. 2012;51(12):2278–2285. [3]Salliot C, Denis A, Dernis E, Andre V, Perdriger A, Albert J-D, et al. Ultrasonography and detection of subclinical joints and tendons involvements in Systemic Lupus erythematosus (SLE) patients: A cross-sectional multicenter study. Joint Bone Spine. 2018;85(6):741–745. Disclosure of Interests None declared